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The client with type 2 diabetes is prescribed prednisone, a steroid, for an acute exacerbation of inflammatory bowel disease (IBD). Which intervention should the nurse discuss with the client?
- A. Take this medication on an empty stomach.
- B. Notify the HCP if experiencing a moon face.
- C. Take the steroid medication as prescribed.
- D. Notify the HCP if the blood glucose is over 160.
Correct Answer: D
Rationale: Prednisone can elevate blood glucose levels, particularly in diabetic patients, so monitoring and reporting elevated glucose (>160 mg/dL) is critical to prevent hyperglycemia complications. Moon face is a side effect but less urgent, and steroids should be taken with food to reduce gastric irritation.
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The client is diagnosed with gastroenteritis. Which laboratory data warrant immediate intervention by the nurse?
- A. A serum sodium level of 137 mEq/L.
- B. Arterial blood gases of pH 7.37, PaO2 95, PaCO2 43, HCO3 24.
- C. A serum potassium level of 3.3 mEq/L.
- D. A stool sample positive for fecal leukocytes.
Correct Answer: C
Rationale: A potassium level of 3.3 mEq/L indicates hypokalemia, risking arrhythmias, especially with diarrhea-related losses, requiring immediate intervention. Normal sodium, ABGs, and fecal leukocytes are less urgent.
The experienced nurse is teaching the new nurse about surgery to repair a hiatal hernia. The experienced nurse is most likely to state that the surgery is becoming more common to prevent which emergency complication?
- A. Severe dysphagia
- B. Esophageal edema
- C. Hernia strangulation
- D. Aspiration
Correct Answer: C
Rationale: A. Although dysphagia is a complication of hiatal hernia, it is not an emergency condition. B. Esophageal edema is not a complication of hiatal hernia. C. A hiatal hernia can become strangulated (Circulation of blood to the hernia is cut off by constriction). Strangulation can occur with any type of hernia. D. Although aspiration is a complication of hiatal hernia, it is not an emergency condition.
The client diagnosed with a hiatal hernia is scheduled for a laparoscopic Nissen fundoplication. Which statement indicates the nurse's teaching is effective?
- A. I will have four (4) to five (5) small incisions.
- B. I will be in the hospital for at least one (1) week.
- C. I will not have any pain because this is laparoscopic surgery.
- D. I will be returning to work the day after my surgery.
Correct Answer: A
Rationale: Laparoscopic Nissen fundoplication involves 4–5 small incisions, indicating effective teaching. Hospital stays are shorter, pain is expected, and return to work takes longer.
The client is admitted with upper right-side abdominal pain. The nurse is concerned that the client may have liver cancer when which serum laboratory test results are elevated?
- A. Creatinine and BUN
- B. α-fetoprotein (AFP)
- C. Phosphorus levels
- D. CA-125 levels
Correct Answer: B
Rationale: A. Elevated serum creatinine and BUN are associated with renal problems. B. Serum α-fetoprotein is a major serum protein synthesized by fetal liver cells, by yolk sac cells, and in small amounts by the fetal GI system. Reappearance of AFP in adults signals pathological problems. In 50% to 75% of clients with liver cancer, serum AFP levels are elevated. C. Elevated serum phosphorus is associated with renal and many other diseases and is not specific to liver cancer. D. CA-125 is a tumor marker for ovarian cancer.
The 22-year-old female who is obese is discussing weight loss programs with the nurse. Which information should the nurse teach?
- A. Jog for two (2) to three (3) hours every day.
- B. Lifestyle behaviors must be modified.
- C. Eat one (1) large meal every day in the evening.
- D. Eat 1,000 calories a day and don't take vitamins.
Correct Answer: B
Rationale: Modifying lifestyle behaviors (e.g., diet, exercise, habits) is essential for sustainable weight loss. Excessive jogging, one large meal, or extreme calorie restriction are unsafe.